(Originally published in Diabetes Mine, 5/2/2016)
Here we go again. Another wave of breathless new stories about a “cure” for diabetes (both type 1 and type 2) engulfed us in early February.
Two different headlines for an Associated Press story blared: “Johnson & Johnson, ViaCyte test possible diabetes cure ” and “Diabetes cure? Researchers may have found it.” Kids who read Youth Health Magazine got their hopes up with “Permanent Cure for Diabetes in Clinical Trials.”
Who knows? Maybe this one will be different from the whole organ pancreas transplants or the islet cell transplants that have been offering people with diabetes (PWDs) hope for…decades. Or the tuberculosis vaccine. Or the “Biohub.” Or the spammers’ promises of life without insulin and natural herbal cures that still bombard me. That’s just a short list of the unmet expectations I’ve experienced since my Type 1 diabetes was diagnosed in 1962.
The news about ViaCyte’s treatment is indeed promising. It uses embryonic stem cells, which are induced to turn into insulin-producing islet cells in the laboratory. The islets cells are then placed in a small capsule that is implanted under the skin, an “encapsulation” technique meant to ward off the immune attacks that have thwarted islet cell transplants in the past. It has gone well in mice and now the company has announced “encouraging early results” in a human clinical trial (Phase 1) testing safety and efficacy.
AP reported, “If it works as well in patients as it has in animals, it would amount to a cure.” The story quoted a Johns Hopkins researcher: “This one is potentially the real deal…It’s like making a new pancreas that makes all the hormones’ needed to control blood sugar.”
I have no doubt that the scientists working on this therapy are genuinely excited. And
there is absolutely no reason to be critical of ViaCyte, which may well be our knight in encapsulated armor. But when a story about a cure surfaces, we in the diabetes community need to dig deep and look for more detail.
You wouldn’t realize it from the vast majority of stories, but ViaCyte’s approach is viewed skeptically by some researchers, notably Dr. Douglas Melton of Harvard’s Stem Cell Institute, whose work prompted media coverage back in October, 2014. That research effort sought to produce a virtually unlimited supply of islet cells. In a news story last year, Melton worried that the ViaCyte system might not work. Among other problems, he said the immature stem cells used by ViaCyte will take too long to be fully functional and “many won’t become beta cells, winding up as other types of pancreatic cells instead.”
Are you more skeptical now? Good. That’s healthy.
Very few people in the world are qualified to assess whether Melton is correct, and I’m certainly not one of them. But I do know that he and his colleagues fiercely compete with ViaCyte not only for research funds but also for media attention. Indeed, it’s hard to believe it was coincidental that stories about a different stem cell breakthrough by Melton and his colleagues appeared at about the same time the ViaCyte news broke.
On Feb. 1, Diabetes News Journal announced: “New Type 1 Diabetes Insulin Treatment Allows Insulin-producing Cells to Thrive.” Reporting on two separate studies by Melton’s team, the story noted that mature stem cells in a protective capsule had prompted diabetic mice to release insulin for an extended period of time. According to Melton, “there may be a way to overcome one of the major hurdles that have stood in the way of a cure for type 1 diabetes. Now,..we have stem cell-derived beta cells that can provide insulin in a device that appears capable of protecting them from immune attack.”
We should be happy about competition between some very brilliant scientists. That fuels innovation. Moreover, there is nothing wrong with competing p.r. campaigns that reach investors, private foundations and, oh yeah, the rest of us out here who are waiting and hoping that someone somewhere will find answers.
But how much hope should we allow ourselves to have? In the past, researchers didn’t anticipate daunting roadblocks to a cure for diabetes.
In 1995, Paul Lacy — a researcher who pioneered islet cell transplants in the late 1970s — told Scientific American that, due to improvements in immunosuppressive drugs, “there is good reason to think that this potentially curative therapy will be available to many patients within five years.”
If I had received a hundred dollars every time scientists or fundraisers said a cure was five or ten years down the road, I could have paid for a few nice family vacations in the Caribbean.
I recently shared the ViaCyte news with my Facebook group of Joslin Gold Medalists who’ve all had T1D for at least 50 years. Most, like me, have been burned too many times and take a skeptical, we’ll believe-it-when-we-see it attitude.
But we are all rooting, really hard, as one Medalist put it, “for all the babies and young kids with type 1 now. I hope they will be able to experience a cure in their lifetime.”
I believe they will. I believe it’s going to happen. PWDs and their relatives should never stop hoping for a cure. But we shouldn’t allow ourselves to get all worked up about media hype that promises or implies that it’s coming soon.